左室射血分数对心力衰竭的诊断价值研究  

The Research of Diagnostic Value of Left Ventricular Ejection Fraction in Heart Failure

作　　者：方显明[1] 林荣荣[1] 方兴[1] 潘朝锌[2] 吴海珊[2] 刘雪玲[2] 伍业冬[2] 

机构地区：[1]广西中医药大学,南宁530001 [2]广西中医药大学第一附属医院

出　　处：《中西医结合心脑血管病杂志》2015年第14期1593-1595,共3页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

摘　　要：目的评价左室射血分数(LVEF)对心力衰竭的诊断价值。方法采用心力衰竭标志物N-末端脑利钠肽原(NT-pro BNP)作为金标准,用心脏超声仪M型方法测定左室收缩功能(LVEF)值作为心力衰竭诊断试验指标,对134例心力衰竭住院患者分别进行盲法检测,并计算其敏感性、特异性、预测值与似然比。结果该项诊断试验敏感性和特异性分别为74.04%、73.33%,阳性预测值和阴性预测值分别为90.59%、44.90%,阳性似然比和阴性似然比分别为2.78、0.35。结论 LVEF对心力衰竭有一定的辅助诊断价值,但存在一定的误诊(27%)和漏诊(26%)。故不能单纯依赖LVEF值进行心力衰竭诊断,而应结合临床症状和纽约心脏病协会(NYHA)心功能分级加以诊断。Objective To evaluate the diagnostic value of left ventricular ejection fraction（ LVEF） in heart failure. Methods N-terminal probrain natriuretic peptide（ NT-pro BNP） was measured by 411 type electrochemistry luminescence instrument for gold standard and LVEF was measured by B-ULTRASONIC with m type for diagnostic test indexs with blind method in 134 cases of patients with heart failure. Then the value of their sensibility,specificity,predicted and likelihood ratio were counted respectively. Results The value of sensibility and specificity were 74. 04% and 73. 33%,respectively. The positive predicted value and nagtive predicted value were 90. 59% and 44. 90%,respectively. The value of positive likelihood ratio and nagtive likelihood ratio were 2. 78 and 0. 35 respectively in the diagnostic test. Conclusion LVEF had certain assist diagnostic value in clinical practice,but there were some misdiagnosis（ 27%） and missing diagnosis（ 26%）. LVEF could not diagnosed heart failure by alone. That clinical symptoms combined with NYNA cardiac function grading were necesary on diagnosis of heart failure.

关 键 词：心力衰竭 左室射血分数 脑利钠肽前体 诊断试验 

分 类 号：R541.6[医药卫生—心血管疾病] R256.2[医药卫生—内科学]